This form is a Complaint For Declaratory Judgment To Determine ERISA Coverage. Adapt to your specific circumstances. Don't reinvent the wheel, save time and money.
Erisa Complaint Sample Form In Nassau
Category:
State:
Multi-State
County:
Nassau
Control #:
US-000273
Format:
Word;
Rich Text
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FAQ
Contact your regional EBSA office to file a complaint or an appeal after exhausting your insurance appeals process. You can also find ERISA information through the U.S. Department of Labor online at .dol/ebsa.
Phone: 516-571-7755 Press 1 to report Sexual Abuse, Child Abuse, or Elder Abuse. Press 2 to report Tax, Welfare or Medicaid Fraud. Press 3 to report Frauds targeting immigrants. Press 4 to report Insurance Fraud. Press 5 to report Firearms, Narcotics or Gang Activity. Press 6 to report Corruption.
Filing your complaint starts your case, but the summons is the document that is issued under the court's authority that notifies your defendant they are being sued and that they need to take action.
All complaints are kept anonymous. Call (516) 227-9717.
File a complaint with government or consumer programs File a complaint with your local consumer protection office. Notify the Better Business Bureau (BBB) in your area about your problem. The BBB tries to resolve complaints against companies. Report scams and suspicious communications to the Federal Trade Commission.
File Complaint Online: Mail/Fax: Mailing Address: NYC Department of Consumer and Worker Protection. Consumer Services Division. 42 Broadway, 9th Floor. New York, NY 10004. Fax: (212) 487-4482.
The employer maintaining the plan or the plan administrator of a Pension or Welfare benefit plan covered by ERISA. File Form 5500 to report information on the qualification of the plan, its financial condition, investments and the operations of the plan.
Form 5500-SF: Small plans (those with fewer than 100 participants as of the beginning of the plan year) Form 5500: Large plans (those with 100 or more participants as of the beginning of the plan year)
Common ERISA violations include denying benefits improperly, breaching fiduciary duties, and interfering with employee rights under the plan.
About the Form 5500 Any administrator or sponsor of an employee benefit plan subject to ERISA must file information about each benefit plan every year (pursuant to Code section 6058 and ERISA sections 104 and 4065).